Interstitial Lung disease *

Question 1

Granulomatous ILD

Answer 1

Sarcoidosis

Question 2

Inhalational ILD

Answer 2

Hypersensitivity Pneumonitis

Pneumoconiosis (Occupational)

Question 3

Idiopathic ILD

Answer 3

Pulmonary Fibrosis (MC)

Question 4

Connective Tissue ILD

Answer 4

RA

Scleroderma

Question 5

What is the MC ILD

Answer 5

Pulmonary Fibrosis

Question 6

What are the RF for Pulmonary Fibrosis

Answer 6

Old male smokers
Occupational
Methotrexate user
EBV/CMV

Question 7

What are the presentations of Pulmonary fibrosis

Answer 7

Exertional dyspnoae

Dry cough

Question 8

What is the pathology of pulmonary fibrosis

Answer 8

Progressive lung scarring = T1 resp fail

Question 9

What type of resp fail is pulmonary fibrosis

Answer 9

T1 (Fibrosis so improper filling)

Question 10

How is Pulmonary fibrosis Investigated

Answer 10

Spirometry = Restriction
FEV1/FVC >0.7 w/
High Resolution CT = Ground glass lungs and traction bronchiectasia

Question 11

How would you describe the image of Pulmonary fibrosis on a chest CT

Answer 11

Ground glass

Traction Bronchiectasia

Question 12

How would you manage Pulmonary Fibrosis

Answer 12

Smoking cessation and Vaccine
Pirfenidone / Nintendinir
Lung transplant

Question 13

What medication can be given for pulmonary fibrosis

Answer 13

Pirfenidone / Nintendinir

Question 14

What is Pneumoconiosis

Answer 14

Occupational ILD

Question 15

What are the two causatives of Pneumoconiosis

Answer 15

Silicosis

Abestosis

Question 16

How can silicosis cause pneumoconiosis

Answer 16

Inhale silicon dioxide = eggshell calcification @ hilar lymph nodes

Question 17

How can Asbestosis cause pneumoconiosis

Answer 17

Inhale asbestos = affected pleura = Mesothelioma (T1 RF)

Question 18

What is sarcoidosis

Answer 18

Idiopathic granulomatous ILD

Question 19

What are the RF for sarcoidosis

Answer 19

Women
20-40
Afro caribbean

Question 20

How does a patient present w/ Sarcoidosis

Answer 20

Fever and fatigue
Dry cough and dyspnoea
Uveitis
Lupus Pemio (Blue/red nodules on nose/cheeks)

Question 21

What is Lupus Pemio

Answer 21

Blue-red nodules on nose and cheeks

-Found in Sarcoidosis

Question 22

How is Sarcoidosis investigated

Answer 22

CXR =Bilateral hilar adenopathy and Pulmonary infiltrates
Biopsy = Non caseating granuloma
Raised Calcium and Serum ACE(Granuloma)

Question 23

How is Sarcoidosis managed

Answer 23

Corticosteroids if Symptomatic

Question 24

What is Hypersensitivity Pneumonitis

Answer 24

T3 Hypersensitivity  (Antibody to antigen complex deposition)
@lung tissue causing Immune hyperresponse

Question 25

What are the RF for HS Pneumonitis

Answer 25

Occupation (Farming and bird keeping)

Question 26

What causes farmer's lung Pneumonitis

Answer 26

Mouldy Hay

Question 27

What causes Pigeon Fancier's lung in pneumonitis

Answer 27

Avian protein in bird droppings

Question 28

How can HS Pneumonitis be managed

Answer 28

Removing the allergen

Question 29

What is Good pasture's Syndome

Answer 29

T2 Autoimmune HS reaction caused by Anti GBM

Question 30

What is the pathology of GoodPastures

Answer 30

Anti GBM attacks lungs (fibrosis) and kidneys (GN)

Question 31

How is Good Pastures Investigated

Answer 31

Lung and kidney biopsy for damage and IgA Deposition | Anti GBM positive

Question 32

What antibody is produced in Good pastures

Answer 32

Anti GBM

Question 33

How is Good pastures managed

Answer 33

Supportive Corticosteroids Plasma exchange (remove Anti GBM)

Question 34

What is Wegener's GPA

Answer 34

Granulomatosis w/ Polyangitis | -Small/Medium cell Vasculitis affecting ELK (ENT, Lung and Kidney)

Question 35

What are the presentations of Wegener's

Answer 35

ENT - Saddle nose and ear infection Lungs = Diffuse Alveolar haemorrhage = Haemoptysia Kidney = GN = Haematuria

Question 36

How does Wegener's affect the ENT

Answer 36

Saddle shaped nose and ear infection

Question 37

How does Wegener's affect the kidney

Answer 37

GN causing haematuria

Question 38

How does Wegener's affect the Lungs

Answer 38

Diffuse alveolar haemorrhage = Haemoptysia

Question 39

What is the diagnostic serology for Wegener's EGPA

Answer 39

cANCA

Question 40

How can the serology of Wegeners GPA and MPA be differentiated

Answer 40

wGPA =cANCA | MPA = pANCA

Question 41

How is Wegener's GPA Treated

Answer 41

Corticosteroids | Rituximab for immunosuppressed